泌尿系造影诊断下腔静脉后输尿管

Diagnosis of retrocaval ureter

目的提高下腔静脉后输尿管病的诊治水平。方法回顾性分析7例经手术证实的下腔静脉后输尿管,诊断主要依据静脉尿路造影(IVU)、逆行尿路造影(RP)、B超及CT检查。结果经IVU、RP、B超及CT检查,所有病例在术前均获得明确诊断;IVU显示5例上段输尿管扩张呈典型的反"J"状,2例呈"锥形"改变;RP显示输尿管导管呈"S"形;CT扫描显示下腔静脉与腹主动脉间圆点状输尿管充盈影。结论泌尿系造影检查是诊断下腔静脉后输尿管的可靠方法。

Objective To evaluate the diagnostic value and limitation oi urography m retrocaval ureter. Methods 7 cases with retrocaval ureter confirmed by operation were retrospectively reviewed. Intravenous urography（IVU） and retrograde yelography （RP） were performed in all cases. Results All cases were defi- nitely diagnosed by urography,ultrosonography and computed tomography before operation. On IVU, the dila- tion of the right pelvicalyceal system and upper ureter formed a characteristic reversed J-shape in 10 cases and tapering in 2 cases. On RP, the catheter presented S-shaped appearance. CT scan revealed opacifieation of ure- ter posterior to inferior vena eava, and scan at lower level revealed the ureter medial to vena cava and just ante- rior to vertebral body. Conclusion Urography is a reliable method for the diagnosis of retrocaval ureter.